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Risk factors and predictors of mortality in children after ejection from motor vehicle crashes
M G Scheidler1, B L Shultz, L Schall
1Department of Surgery, University of Pittsburgh, Pennsylvania, USA.
Insights
Ejection from motor vehicle crashes (MVCs) significantly increases child mortality, with most ejected children being unrestrained. Head injuries are the leading cause of death, highlighting the need for increased public awareness and restraint use.
Area of Science:
- Pediatric trauma research
- Motor vehicle safety
- Public health
Background:
- Child mortality from motor vehicle crashes (MVCs) is understudied.
- Ejection from vehicles poses a significant risk.
Purpose of the Study:
- To examine fatalities from ejection after MVCs in children.
- To identify risk factors and predictors of mortality in ejected children.
Main Methods:
- Retrospective review of Pennsylvania Trauma Outcome Study data (1993-1997).
- Analysis of patients aged 0-16 years involved in MVCs.
- Examination of mortality, injury severity, and restraint use.
Main Results:
- 189 children were ejected from 2,298 MVCs; 88% were unrestrained.
- Ejection nearly tripled mortality and increased Injury Severity Score.
- Head injuries were the primary cause of death across all age groups.
Conclusions:
- Most ejected children were unrestrained or improperly restrained.
- Head trauma is the leading cause of death in ejected children.
- Educational programs are needed to increase restraint use and awareness.
Purpose:
Mortality after ejection from a motor vehicle crash (MVC) has been studied extensively in adults. The magnitude of this problem in children is relatively unknown. We retrospectively examined fatalities resulting from ejection after MVC in the state of Pennsylvania to define risk factors and predictors of mortality in children.
Methods:
The records for all patients 0 to 16 years of age involved in an MVC and entered in the Pennsylvania Trauma Outcome Study between 1993 and 1997 were reviewed. We examined mortality, length of hospitalization, major injuries sustained, and impact of safety restraint devices. Significant differences were determined using chi2 test.
Results:
There were 2,298 children involved in MVCs during this period; 189 were ejected. A total of 77% of the ejected passengers were greater than 10 years of age, 16% were 0 to 4 years of age, and 7% were 5 to 9 years of age. Overall, 88% of the ejected occupants were unrestrained. Ejection nearly tripled the overall mortality rate and significantly increased the Injury Severity Score for each age group. Infants and children 0 to 4 years of age had the highest fatality rate despite having a lower Injury Severity Score than all other age groups. Head injuries accounted for the majority of deaths in all age groups. Children older than 10 years of age had a higher incidence of associated chest, abdominal, and pelvic injuries.
Conclusion:
Our data show that most children ejected from MVCs were either unrestrained or improperly restrained. Head injuries were the most common cause of death in all age groups. Greater public awareness through educational programs targeting parents and children at risk may reduce this serious problem.